Individual provider Active NPI

Michael Shane Garcia, CDPT

  • Clinical Social Worker
  • Spokane, WA
National Provider Identifier
1619126851
Registry record updated Apr 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
1803 W Maxwell Ave
Spokane, WA 99201-2831
Phone
(509) 325-5502
Fax
(509) 325-9839
NPI assigned
Sep 11, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X RC60002973 WA
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

1803 W Maxwell Ave
Spokane, WA 99201-2831

Mailing address

1803 W Maxwell Ave
Spokane, WA 99201-2831
Phone (509) 325-5502

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230303000055 WA Practitioner - Clinical Social Worker 5193113207 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RC60002973WAMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Native Project Clinical CurrentSince Nov 22, 2022 Accepting new patients

Locations

1803 W Maxwell Ave
Spokane, WA 99201
Phone (509) 325-5502

Interoperability endpoints

  • Direct secure messaging: mgarcia@nativeproject.directbygreenway.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1221091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586736000000",
    "number": "1619126851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1803 W MAXWELL AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992012831",
            "telephone_number": "509-325-5502",
            "fax_number": "509-325-9839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1803 W MAXWELL AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992012831",
            "telephone_number": "509-325-5502",
            "fax_number": "509-325-9839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "MICHAEL",
        "middle_name": "SHANE",
        "credential": "CDPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-11",
        "last_updated": "2020-04-13",
        "certification_date": "2020-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "WA",
            "license": "RC60002973",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

Verify at the official NPI Registry.